What is an episiotomy?

Episiotomies are performed when a very large baby is anticipated, if a baby gets stuck, or if a change in the baby's heart rate signals the baby may be in distress and need to be delivered quickly. If it appears that delivery may cause damage to the top of the vaginal area, the doctor may decide to do an episiotomy to relieve the pressure and prevent a painful tear.

YOU: Having a Baby: The Owner's Manual to a Happy and Healthy Pregnancy

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YOU: Having a Baby: The Owner's Manual to a Happy and Healthy Pregnancy

Can I get a cavity filled while pregnant? Will avoiding spicy foods make my kid a picky eater? Can I really increase my baby's IQ while she's in utero? Whether you're pregnant for the first time,...
Boston Women's Health Book Collective
Administration Specialist

An episiotomy is an incision made along the perineum, which is the area between the vagina and the rectum, to allow more room for the baby. Episiotomy can speed delivery by a few minutes, but normally there is no need to hurry the process. An episiotomy may be necessary in rare circumstances, if there is concern about the baby's condition.

Episiotomies increase the chance that you will have a more severe tear that extends into the rectum; in general, naturally occurring tears are less extensive and not as deep. Despite extensive, well-documented evidence that routine episiotomy does more harm than good, some obstetricians in the United States still do the procedure at all or almost all births. Ask your provider during prenatal care what her or his group usually does, and discuss your thoughts about it. Since episiotomy is a surgical procedure, practitioners should obtain consent from the woman involved. If you are having an unmedicated birth, your perineum can be numbed with a local painkiller such as Novocaine so that you do not feel the incision.

Our Bodies, Ourselves: Pregnancy and Birth

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Our Bodies, Ourselves: Pregnancy and Birth

An episiotomy is a procedure where the tissue is cut between the vagina and the rectum to help facilitate delivery of the baby's head. At one time, they were fairly routine for two reasons. One, it would facilitate a quicker delivery. Two, it was thought that there would be less trauma to the birth canal and the vaginal tissues, and that it would decrease the complications that can occur afterwards to the bowel and the bladder. Since that time, studies have shown that episiotomies do not decrease the risk of bowel or bladder problems after delivery. They also increase the risk of having a more significant tear.
Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

An episiotomy is a surgical cut made to enlarge the vagina to help during childbirth. Learn more about this topic in this video from Dr. Oz.

Dr. Jeanne Morrison, PhD
Family Practitioner

An episiotomy is a procedure in which an incision is made in the perineum to enlarge the vaginal outlet. As the baby is crowning, the physician or certified nurse midwife number the vaginal area and perineal area and made the incision.  There are two types of episiotomies:

  • Mediolateral:  the cut is angled down away from the vagina and anus and into the muscle
  • Midline: the cut is straight beginning at the vagina and going towards the anus.

An episiotomy provides more room to delivery the baby and may be used in complicated births, if the baby is large or if there is concern about the baby’s well-being. Routine episiotomies are not recommended.   After the baby and placenta are delivered the episiotomy is stitched closed.  

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.